Principles of Toxicologic Management

First Things First

• ABC’s with Tox in mind:
  • A: airway, antidotes
  • B: breathing
  • C: circulation, c-spine
  • D: disability, decontamination
  • E: exposure, enhanced elimination
• Remember the coma cocktail: “DON’T”
  • Dextrose: check peripheral glucose
    • 1 amp D50W IV for adults
    • 10 mL/kg of D10W IV for children
  • Oxygen: check O2 sats
  • Naloxone: for the opioid toxidrome
    • 0.4 mg IV/IM, titrate up based on adequacy of respirations
  • Thiamine: all malnourished patients, especially alcoholics
    • 100 mg IV